Drugs may have distinctive benefits but diverse risks. Narrow therapeutic index (NTI) drugs as those pharmaceuticals having a narrowly defined range between risk and benefit. Drug related problems (DRP’s) are serious complications representing significant morbidity, mortality and economic liability. Medication reviewing (MR) plays a pivotal role in resolving DRP’s as it involves the review of a patient’s medication regimen to ensure that therapy is appropriate, safe, efficacious and cost effective.

Aims & Objectives: To evaluate prescription pattern of NTI drugs and to identify DRP’s associated with it.

Methodology: An interventional study was carried out at Gulbarga Institute of Medical Sciences (GIMS) Hospital, Kalaburagi city. Data was collected from the patient files and laboratory reports. Microsoft Excel versions 2007/2010 was used for database entries. statistical analysis we emphasized, for quantitative data analysis mean and standard deviations were calculated un-paired t-test was applied for statistical significance and correlation coefficient test, for qualitative data analysis chi-square and chi-square yates correction test was applied for statistical significance.

Results: A total of 143 patients were enrolled in the study, and 107 DRP’s were observed in which 10 intervention were performed. Drug-drug interaction (DDI) was found to be the most common DRP. Poly pharmacy and length of stay are the contributory factors for the development of DRP’s whereas Age, gender and co morbidities plays no such significant role. Conclusion: The therapy associated with NTI should be monitored in order to bring awareness in the healthcare system regarding the safe and effective use of NTI.

[1] Bemt VD, Egberts ACG. Drug-related problems: definitions and classification, Euro J. of Hosp pract, 2007;13(1):62-64.

[2] Roshan R, Yogananda R, Reddy BS. Narrow therapeutics index drugs- a critical study on prescription trends in south Indian tertiary care hospital, world J. of pharma. research, 2018;7(19):834-860.

[3] Beran RG. Generic Substitution in Patients Whose Illness Has a Narrow Therapeutic Index, Such as Epilepsy. Annal of Pub Health & Epidemiology,2021;1(2):1-5.

[4] Iyer K, Dilipkumar N, Vasaya S, Pawar S, Diwan A. Comparison of Drug Related Problems Associated with Use of Narrow Therapeutic Index Drugs and Other Drugs in Hospitalized Patients, J. of Young Pharmacists,2018;10(3):318-321

[5] Hepler CD, Strand M L. Opportunities and responsibilities in pharmaceutical care, American J. of Hosp pharm,1990;(43):533-543.

[6] Pemmasani D, Gali SD, Arcot M, Prasad DTS. Assessment of drug related problems and clinical pharmacist interventions in pediatric department of a tertiary care teaching hospital, Int J Basic Clin Pharmacol. 2018 Oct;7(10):1934-1939

[7] Kovacevic SV, Miljkovic B, Culafic M, et al. Evaluation of drug‐related problems in older polypharmacy primary care patients. J Eval Clin Pract. 2017;23:860–865

[8] Greeshma M, Lincy S, Maheswari E, Tharanath S, Viswam S. Identification of Drug Related Problems by Clini Pharmacist in Prescriptions with Polypharmacy: A Prospective Interventional Study. J Young Pharm. 2018;10(4):460-5.

[9] Garin, N., Sole, N., Lucas, B. et al. Drug related problems in clinical practice: a cross-sectional study on their prevalence, risk factors and associated pharmaceutical interventions. Sci Rep 2021(11):883

[10] Bobrova V, Fialová D, Desselle S, Heinämäki J and Volmer D.Identifying Potential Drug-Related Problems Among Geriatric Patients with Use of an Integrated Clinical Decision Support Tool, Frontiers in pharmaco,2022;(13): 1-10

[10] V1da B J et al. Drug-related problems in patients admitted for SARS-CoV-2 infection during the COVID-19 pandemic, Front pharmacol,2022;(10):1-08

[12] Kumar MV, Pasha M, Gandla V, Borampeta P, Mudugu S. Drug Related Problems Identified by Clinical Pharmacist in a Tertiary Care Hospital in South India: An Observational Study, Ind J of Pharm Pract 2022;3(15):198-204.

[13] Shargel L, Andrew B.C. Medication therapy management, A Textbook of Applied biopharmaceutics and pharmacokinetics 2012(7):681-690.

[14]Bismi S, Chandran C, Davis DM, Dhanya SS, Dharman D, Dharan SS. A Prospective Interventional Study on Prescription Auditing and Adverse Drug Reaction Monitoring in a tertiary Care Teaching Hospital in South Kerala. Int J Med Public Health. 2021;11(4):206-14

[15] Acheampong et al. Drug-related problems and their clinical interventions in a Ghanaian teaching hospital, Safety in Health2016;2(15):1-7.